<form id="edit-form" class="form-horizontal" role="form1" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">提现金额:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-actual_price" data-rule="required" readonly=“readonly class="form-control" name="row[actual_price]" type="text" value="{$row.actual_price|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">提现比例:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rate" data-rule="required" readonly=“readonly class="form-control" name="row[rate]" type="text" value="{$row.rate|htmlentities}">
        </div>
    </div>
   <input  name="row[order_id_list]" type="hidden" value="{$row.order_id_list|htmlentities}">
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed ">{:__('OK')}</button>
        </div>
    </div>
</form>
